Longitudinal prevalence of inpatient diabetes mellitus in an Australian hospital across five decades: 1972–2019

Wang, Ray; Colman, Peter G; Kyi, Mervyn; Russell, Nicholas; Fourlanos, Spiros

doi:10.1111/imj.15322

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…While it is difficult to accurately assess its prevalence, gastric emptying may be delayed in up to 30% of patients with long‐standing diabetes 6 . At our institution, a point prevalence survey identified one quarter of inpatients as having diabetes, and there are 10 272 outpatients registered in our ambulatory care RMH BioGrid Diabetes Database, which spans the last two decades 12,13 . Yet, only 106 (1.0%) of the patients in the RMH BioGrid Diabetes Database have diabetic gastroparesis documented.…”

Section: Discussionmentioning

confidence: 99%

“…6 At our institution, a point prevalence survey identified one quarter of inpatients as having diabetes, and there are 10 272 outpatients registered in our ambulatory care RMH BioGrid Diabetes Database, which spans the last two decades. 12,13 Yet, only 106 (1.0%) of the patients in the RMH BioGrid Diabetes Database have diabetic gastroparesis documented. In an alternative audit of EPIC (electronic medical record) from September 2020 until August 2022, there were 2964 patients seen in our diabetes clinics.…”

Section: Discussionmentioning

confidence: 99%

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Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting

Gong,

Sivaratnam,

Armstrong

et al. 2023

Internal Medicine Journal

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Delayed gastric emptying occurs in up to 30% of patients with long‐standing diabetes and causes significant morbidity. We performed a retrospective cohort study of 341 patients who had participated in a gastric emptying study from 2018 to 2021 in a large teaching hospital. Given the expected prevalence of gastroparesis in people with diabetes, there were fewer studies than anticipated, which could lead to gastroparesis underrecognition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting

Gong,

Sivaratnam,

Armstrong

et al. 2023

Internal Medicine Journal

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“…Diabetes is present in up to one-quarter of inpatients and its prevalence is increasing in parallel to the diabetes prevalence in the community. 1 The presence of diabetes, hyperglycemia, and/or hypoglycemia during hospitalization is associated with adverse outcomes such as hospital-acquired infection, longer length of stay, and increased mortality. [2][3][4] Hence, multiple quality improvement initiatives have been implemented to minimize hyperglycemia and hypoglycemia, 5,6 and glucometric indices are monitored and benchmarked in many health systems.…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes is present in up to one‐quarter of inpatients and its prevalence is increasing in parallel to the diabetes prevalence in the community 1 . The presence of diabetes, hyperglycemia, and/or hypoglycemia during hospitalization is associated with adverse outcomes such as hospital‐acquired infection, longer length of stay, and increased mortality 2‐4 .…”

Section: Introductionmentioning

confidence: 99%

Early intervention model of inpatient diabetes care improves glycemia following hospitalization

Kyi

Colman

Gonzalez

et al. 2023

Journal of Hospital Medicine

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Admission to hospital provides an opportunity to optimize long-term diabetes management, but clinical inertia is common. We previously reported the randomized study of a proactive inpatient diabetes service (RAPIDS), investigating an early intervention model of care and demonstrated improved in-hospital glycemia and clinical outcomes. This follow-up study assessed whether proactive care in hospital improved postdischarge HbA1c. In a subgroup of 298 RAPIDS trial participants with type 2 diabetes, age <80 years, and admission HbA1c ≥ 7.0%, diabetes treatment intensification occurred more often in early intervention versus usual care groups (37% vs. 19% [p = .001]), adjusted odds ratio 3.2 (95% confidence interval [CI]: 1.7-6.0). There was a greater change in HbA1c in the early intervention group (mean −0.9% [95% CI −1.3 to −0.4]) versus the usual care group (−0.3% [−0.6 to −0.1]), p = .029. The value of acute care by dedicated inpatient diabetes teams can extend beyond improving inpatient clinical outcomes and can lead to sustained improvement in glycemia.

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“… 7 , 8 , 9 , 10 , 11 Similarly, those with diabetes or uncontrolled hyperglycaemia have been shown to have higher mortality than those with neither (28.8 vs 6.2%). 11 With approximately 5% of the Australian population 12 and up to 35% of Melbourne hospital inpatients having known diabetes, 13 , 14 it is likely that diabetes is a significant co‐factor in COVID‐19 morbidity and mortality in Australia.…”

Section: Introductionmentioning

confidence: 99%

Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations

Barmanray

Gong

Kyi

et al. 2022

Internal Medicine Journal

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Background and Aims A relationship between diabetes, glucose and COVID‐19 outcomes has been reported in international cohorts. This study aimed to assess the relationship between diabetes, hyperglycaemia and patient outcomes in those hospitalised with COVID‐19 during the first year of the Victorian pandemic prior to novel variants and vaccinations. Design, setting Retrospective cohort study from March to November 2020 across five public health services in Melbourne, Australia. Participants All consecutive adult patients admitted to acute wards of participating institutions during the study period with a diagnosis of COVID‐19, comprising a large proportion of patients from residential care facilities and following dexamethasone becoming standard‐of‐care. Admissions in patients without known diabetes and without inpatient glucose testing were excluded. Results The DINGO COVID‐19 cohort comprised 840 admissions. In 438 admissions (52%), there was no known diabetes or in‐hospital hyperglycaemia, in 298 (35%) patients had known diabetes, and in 104 (12%) patients had hyperglycaemia without known diabetes. ICU admission was more common in those with diabetes (20%) and hyperglycaemia without diabetes (49%) than those with neither (11%, P < 0.001 for all comparisons). Mortality was higher in those with diabetes (24%) than those without diabetes or hyperglycaemia (16%, P = 0.02) but no difference between those with in‐hospital hyperglycaemia and either of the other groups. On multivariable analysis, hyperglycaemia was associated with increased ICU admission (adjusted odds ratio (aOR) 6.7, 95% confidence interval (95% CI) 4.0–12, P < 0.001) and longer length of stay (aOR 173, 95% CI 11–2793, P < 0.001), while diabetes was associated with reduced ICU admission (aOR 0.55, 95% CI 0.33–0.94, P = 0.03). Neither diabetes nor hyperglycaemia was independently associated with in‐hospital mortality. Conclusions During the first year of the COVID‐19 pandemic, in‐hospital hyperglycaemia and known diabetes were not associated with in‐hospital mortality, contrasting with published international experiences. This likely mainly relates to hyperglycaemia indicating receipt of mortality‐reducing dexamethasone therapy. These differences in published experiences underscore the importance of understanding population and clinical treatment factors affecting glycaemia and COVID‐19 morbidity within both local and global contexts.

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Longitudinal prevalence of inpatient diabetes mellitus in an Australian hospital across five decades: 1972–2019

Cited by 9 publications

References 3 publications

Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting

Underutilisation of gastric emptying studies and underrecognition of gastroparesis in people with diabetes treated in a hospital setting

Early intervention model of inpatient diabetes care improves glycemia following hospitalization

Diabetes IN hospital – Glucose and Outcomes in the COVID‐19 pandemic (DINGO COVID‐19): the 2020 Melbourne hospital experience prior to novel variants and vaccinations

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